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. 2025 May 16:10.1007/s10578-025-01852-0.
doi: 10.1007/s10578-025-01852-0. Online ahead of print.

Breaking the Cycle: Predicting Agitation Crises in Child and Adolescent Inpatient Psychiatry

Ricky Burns  1   2 , Sean T Lynch  3 , Paige Staudenmaier  3   4 , Timothy D Becker  3   5   6 , Parul Shanker  3   7 , Dalton Martin  3 , Alicia Leong  3 , Timothy Rice  3
Affiliations

Breaking the Cycle: Predicting Agitation Crises in Child and Adolescent Inpatient Psychiatry

Ricky Burns et al. Child Psychiatry Hum Dev. .

Abstract

This study examined biopsychosocial factors associated with the use of intramuscular (IM) agitation emergency medication in child and adolescent psychiatric inpatients. A retrospective review of 1,101 patients hospitalized between June 2018-November 2021 at an urban teaching hospital identified predictors of IM medication use through linear regression analysis. Among these patients, 196 received IM medication during their stay. Female sex was associated with a lower likelihood of receiving IM treatment, while factors such as prior involvement with child protective services, a history of violence, previous psychiatric hospitalizations, and use of multiple home psychiatric medications increased the likelihood. Agitation episodes pose risks to both patients and staff, underscoring the importance of early identification and intervention. Understanding these risk factors may guide proactive strategies to reduce the frequency and severity of agitation and limit reliance on emergency pharmacological interventions. Further research is needed to refine predictive models and explore non-pharmacological management approaches.

Keywords: Agitation; Child and adolescent psychiatry; Emergency medicine; Inpatient psychiatry; Risk factors.

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Conflict of interest statement

Declarations. Competing Interests: The authors declare no competing interests.

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